Provider Demographics
NPI:1720584162
Name:COUCH, ANTHONY C
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:C
Last Name:COUCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 S ERIE HWY
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-4315
Mailing Address - Country:US
Mailing Address - Phone:513-299-4028
Mailing Address - Fax:513-737-4603
Practice Address - Street 1:621 S ERIE HWY
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-4315
Practice Address - Country:US
Practice Address - Phone:513-795-7557
Practice Address - Fax:513-737-4603
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)